Q&A With Dr. Stephanie Wong: How COVID19 Affects Our Mental Health

Hi everyone, it’s Yu-Chen. I’ve been listening to Dr. Stephanie Wong’s podcast "The Color of Success" since it began – and the episode with Lillian So on addressing body image issues and racial identity really resonated with me. Just like Lillian, I received endless criticism about my appearance from my Asian family and relatives, which eventually caused me to develop body dysmorphia and bulimia as young as 13 years old. I was in tears just a few minutes in as I felt like she was telling my story. I listen to many similar podcasts and a favorite of mine is Brene Brown’s “Unlocking Us.” However, none of these podcasts spoke to my personal experience as an Asian American woman. I feel that Stephanie’s work in providing a platform for the stories of our diverse community is really crucial, and I’m so excited for you to get to know her better.

Hi Stephanie. Why don’t you start by telling us about yourself and your work.

I'm an Asian American clinical psychologist, mental health advocate, and host of the Color of Success Podcast, which seeks to de-stigmatize mental health among Asians, Asian Americans, and ethnic minorities. I became a psychologist because I observed early on in my life that while Asians were experiencing mental health issues, they were not seeking help. By increasing Asian representation in the profession, this may encourage help-seeking behaviors. I work with veterans who struggle with homelessness, unemployment, depression, PTSD, and other co-morbid disorders, and have a private practice working with Tech professionals. On my podcast, I invite guests to stories of advancing their careers while addressing barriers and mental health challenges. They talk about their successes and failures, strategies to build businesses, brands, and careers, and coping skills to deal with stress, anxiety, discrimination, and self-doubt. We recently launched Season 2 with Andrew Phung from Kim's Convenience!

How have you seen the pandemic affecting our mental health?

COVID-19 and the socio-political pandemic has brought an overarching layer of anxiety and depression due to ambiguity, fear, lack of access to resources, isolation, unemployment, and xenophobia toward specific ethnic groups. Those with pre-existing mental health conditions are further complicated by the societal context. There has been an exponential increase in demand for mental health professionals, further limiting access to services.

Some studies report a large increase in depression particularly among Asians. (CNN) Why are Asian communities more prone to declining mental health due to the pandemic?

This is complex as Asians may be more open to reporting symptoms of depression as of late. Barriers to treating mental health issues earlier than not include stigma, "loss of face," shame, guilt, worry about being labeled "crazy".

Is it possible to suffer from PTSD due to the pandemic? What are some of the symptoms?

The pandemic(s) have brought traumatic experiences that may lead an individual to meet criteria for PTSD. An overview of symptoms can be found here. To meet diagnostic criteria via the Diagnostic Statistical Manual 5, "the exposure to actual or threatened death, serious injury, or sexual violence is experienced in one (or more) of the following ways: 1. Directly experiencing the traumatic event(s) 2. Witnessing, in person, the event(s) as it occurred to others 3. Learning that the traumatic event(s) occurred to a close family member or close friend. In cases of actual or threatened death of a family member, or friend, the event(s) must have been violent or accidental. 4. Experiencing repeated or extreme exposure to aversive details to the traumatic event(s) Note: This does not apply to exposure through electronic media, television, movies, or pictures, unless this exposure is work-related. Symptoms may include memories or dreams that are distressing, flashbacks, distress when exposed to cues of the trauma, persistent avoidance of cues of the trauma, change in thoughts of self and others, and hyper-vigilance. It’s worth noting that to meet criteria, the symptoms must last for more than one month and must cause significant distress or impairment in important areas of one's life (e.g., social, occupational). It also cannot be due to another medical condition or substances. **Acute Stress Disorder may be clinically indicated if symptoms occur 3 days-1 month following the trauma. Therefore, many recent events can meet criteria for a trauma, including hate crimes against specific racial groups (e.g., numerous attacks on elderly Asian individuals), brutality towards Black and/or African American individuals, experiencing COVID-19, seeing a loved one suffer from COVID-19, etc.

How may we begin to heal from the pandemic in 2021? Can you provide some tips?

There are many ways that we can support each other, including building a support network and communities. I emphasize supportive communities because some can reinforce mental health issues and discourage help-seeking. Reach out to professionals to guide you through difficulties whether or not the issues are acute. Many clients seek out professional support when they are in a crisis; seek help when you are feeling a change in thoughts, feelings, and behaviors that are impacting your daily life. Identify resources to share with others (e.g., a list of trusted providers or communities). Have discussions about difficult topics while also implementing boundaries for yourself. For example, set a specific amount of time you will talk about a topic instead of it being open-ended for hours, which can be emotionally draining. Lastly, it comes down to kindness – help one another. Demonstrate empathy.

What is your perspective on the recent rise in attacks and violence against Asian Americans? Why do you think this is happening?

It is absolutely heartbreaking and has led to mixed emotions of fear, anxiety, anger, frustration, and also community mobilization. My perspective is that the Anti-Asian sentiment has been pervasive throughout our history, and has been further fueled recently by the mis-conceptions that Asians and Asian Americans are to "blame" for COVID-19. The previous administration utilized terms as Kung-Flu, which was broadcast to the general public. Additionally, Asians and Asian Americans have been perceived as "model minorities," which assumes we keep a low-profile, work hard, and are successful and wealthy. We know that there is within group and individual differences as to the extent that we do so. I think some Asians/AA are shocked that this is happening because of the assumption that we have assimilated into the majority.

How has this affected your work?

There has been an increased demand for mental health services from Asians/Asian Americans, and providers cannot keep up. Recent events have also contributed to stress among clients, and the intersection of race x mental health have been pertinent to our conversations.

How have you seen this affect your friends, family, and clients?

Many of my peers, family, friends, and clients are understandably fearful, anxious, hurt, and angry, which has led to community mobilization and solidarity. Some have chosen to continue with their daily lives, as this sends a powerful message that these attacks will not stop us from living. Others have taken to social media to raise awareness of the issues, and organizations have launched campaigns to assist the community. There have been great dialogues within and across communities.

How has this affected your mental health? How do you deal with/overcome it?

I share the mixed emotions aforementioned, and have had to monitor feelings of burnout constantly. I am trying to do my part and utilize social media, including holding groups for people to discuss their feelings and perspectives. The podcast is also a way for me to talk about constructive, concrete ways to approach the issue. I have a very supportive family and group of friends that ground me, and we have open dialogue. I have people constantly reminding me to take care of myself! As a result, I have had to set boundaries, and let people know that my private practice is full, and direct them to referrals and resources. The podcast is also my way of giving back to the community because we also discuss coping skills and strategies. I have had conversations with Black/African American friends to broaden my perspective on what may be contributing to the racial tensions and ways to unify our communities. I am grateful to have wonderful people in my life.